Discover the strategic methods for
reaching your maximum potential as a doctor and never
have to worry about having enough income ever again.
Article #45 May 2013
Why Doctors Fail---
"Employed Physicians Are Sacrificial Lambs Whose
Robotized Job Is To Fill the Pockets
of the Employer”
Physician employers pull out of you only what
they need to make the most money from, then
throw the rest of you and your incredible
capabilities and expertise away.
Your value as an employee
is manifested by the
you kowtow to their system rules and by
your productive capabilities.
You aren’t hired
for your looks, personality, how much you know
about medicine or even the medical skills you
have. Jobs for doctors are available to those
physicians who can
see the most patients per day
(earn the most money for
the institution that
I know that because of
how the HMO and another
hospital where I had been employed (total = 8
years) measured an employed doctor’s usefulness
to them by their productivity and profitability.
criterion of measurement was almost
entirely based on how many patients you saw each
day compared to the
When I left my hospital position, the head nurse
in the Women’s Clinic was quick to point out
that the doctor replacing me was able to see 60
patients a day, while I saw an average of only
25 patients per day. Quality of medical care
given was not even mentioned because that wasn’t
important enough. For myself… it was.
I could easily have seen 60 patients a day.
Following that path would have violated every
personal belief I had about patient treatment
Seeing a rapid flow of patients like
that would have left me mentally frustrated,
feeling neglectful of my responsibility to
patients, and more than anything else, would
have documented for me that I had fallen far
short of being a
How do you go about rating the quality of doctor
you are today?
Many shortcomings related to
Your salary and compensation
often stay nearly the same
over the years. The only way
that increases in salary
is if you complain,
threaten to quit, or somehow
become considerably more
useful to them… like take on another
responsibility (work harder... make more
for them). It’s not personal… it’s just good
In private practice you can rather quickly
adjust your income
to a level you are
comfortable with. You control the number
patients you prefer to see.
You are not in charge of your professional
What you would like to
do, beyond your required medical
has to be approved by another higher-level
or administrator, or both. If that
medical practice treatment or procedure in
any way interferes with your profitability
view, you will not be allowed to do
This aggressive push to force physicians to
increase their productivity is even more
extensive in the present
These healthcare facilities are only able to
survive if they make enough money by
persistently pushing their employees harder.
The bottom line is always the profit
motive... never forget that.
as a physician employee at
Kaiser I was
to do what was
necessary to carry out an
infertility workup. I couldn’t keep my nurse
(assigned to me) overtime because of problem
medical issues because it cost Kaiser too
For Kaiser doctors appointments were rigid.
appointments were made and assigned to
me without any
choice by me whatsoever, and
revisit appointments started
from the date I instructed the patient
a revisit at the front desk on
the way out.
Fit in appointments were
it interfered with
my rigid schedule for
seeing patients and because all patients
to be seen by the time the clinic hours
closed. Hour-long consult visits with
patients were not possible. All visits at
time were 20 minutes in length no
Even staff members who suddenly
during clinic hours, finding backup people
to help becomes a chaotic affair.
about that for a minute. The
patient is brought to the exam room by the
nurse. The patient gets into an examination
gown. The patient has a full gyn examination
or OB check. The patient is counseled by the
doctor in the exam room. The doctor returns
to his or her desk to make chart notes, or
to enter the medical information into the
How long does it take for you
to manage all
that effort? Have
you actually time tested
Now assign a number of minutes
to each of
these actions. If
you are any kind of
conscientious practitioner, you probably
will notice that the actual time with the
practicing real medicine,
is unacceptable for most gyn problems.
There is no accountability or time set aside
for emergencies in
the office. There was no
attention given to unhappy patients
would like to kick you in the teeth. There
were no time intervals set aside for
settling doctor-patient disagreements.
present another set of problems
for a physician employee, which are most
often related to department
battles and administrative dictatorial
Working in a hospital environment
is primarily a team effort.
That means you
are subject to open criticism, intimidation,
and very subtle threats at
every turn… and,
Be aware that
the concept of team
management of health
care being promoted
today puts you in a position of
at every turn as well. It’s a concept that
medical patients will be treated better,
have better outcomes and
involve far fewer
medical mistakes being made… maybe.
For example, a few
intolerable things that
I brought along my Ultrasound machine I
had used for 8
years in my private
practice and used it during the first
three months in my
at the hospital Women’s clinic. I was
suddenly without warning forbidden
use it for any reason in my clinic
practice, at risk of
because the radiology
all ultrasounds done
in their department only (by their
tech), so they could earn the money. I
had to wait
3 to 4 days for their report
to come back. I would have
answer for myself in 10 minutes or less.
is a business and it has to
make money… right?
Even more ridiculous was
the fact that
I, nor the women’s clinic, were billing
for the ultrasounds I did on patients.
used ultrasound for improving on my
on the spot. I also
was beginning to teach the Certified
Nurse Midwives how to use it for their
What the “decision makers” were
ignorant of was the PR, publicity,
and marketing that handing an ultrasound
of a patient’s fetus to the mother
does for the hospital’s bottom line over
time. It fries my oysters to think of
the ignorance that persists in the
In addition, the ultrasounds
I did for
myself were never
ones that I would have
referred to the radiology dept. Besides,
I wasn’t so dumb that I would avoid
sending a complicated patient problem to
the radiologists anyway.
The hospital hadn’t a
clue about the
gold mine they had available to them in
my ultrasound use.
I was involved in a hot discussion with
an arrogant nurse in
the clinic hallway
one day, when a supervisor nurse
standing nearby immediately ordered
me in a very loud
voice to take the discussion into
By itself, it was a proper thing to do.
However, she did it
from down the hall
in front of several staff members with
an attitude I could not tolerate. My
response was to forget
the hot argument
instantly, walked down the hall to her
and emphatically instructed her to
never do that
such a manner.
She could have handled that
were perceived by the
as insulting and
threatening to the nurse and who then
threatened me, and my job.
ordered to apologize to the nurse
and I didn’t speak
to her for the next
two years. Not because my anger
persisted, but because I knew she was
more important to
the hospital than I
was, and I was determined not to give
her a chance to
test me again.
This hospital was at least ten years
behind the hospitals I
had worked at in
my private practice in California. I had
already been doing advanced operative
surgery procedures for
When I applied for privileges to
continue these procedures,
that they had no such privileges. I gave
the ones my other hospitals had
used and the surgery committed granted
me those privileges.
I scheduled a LAVH
procedure and ran
into problems immediately with the
process. The OR supervisor had
previously assured me they already had
all the instruments needed to do the
procedure... they didn’t.
I was able to
complete the procedure
properly but with a
instruments, a prolonged procedure, and
my decision to withdraw my privileges to
room staff, I discovered,
had not been
trained for this type
surgery, the necessary instruments
hadn’t been purchased, and
risks were too
As it turned out I was never
teach the other doctors what I knew
about this kind of surgery (they could
have learned a lot from me). I felt
disappointed that I had skills
would never be used again. And the
made no attempt to improve
their skills and capabilities
advanced surgical procedures for the
I was there.
practice, you replace the
nurse immediately. In addition, you are
treated with much more respect when
are paying your office staff salaries.
As an employed physician you are
powerless to make those things happen.
Why? Because it’s easier for the
hospital to replace you
than their own
I know that is true because of an event
during my OBG residency. After an
interchange of words with the Chief of
Service’s secretary one day, the Chief
told me in no
uncertain terms that it
would be “much easier to replace
than it would be to replace his
Remember that each doctor in an
employed position is subject to
professional and personal rules that may not be
tolerable. With the independence factor built
into most medical doctors, every employed
physician can expect to have their independence
compromised in many ways.
Many physicians are
adaptable to the compromises
they must make, because of their personal,
monetary, or personality reasons. However, there
is truth to the fact that every doctor employee
to some degree resents being told what to do.
The aspects that
trouble physician employees the
most are how patients are being treated in
mass-medicine facilities. Medical students
develop a close rapport with their patients and
have an inherent passion to treat them with
respect and dignity. Every graduating
their own well-established ideas about how they
want to treat
the reality of circumstances
within the healthcare organization they work for
inevitably chip away at those ideal patient
treatment concepts. It continues until they have
indoctrinated doctors into compromising almost
everything they had learned and believed about
how medicine should
doctors reach their ethical, moral
and principled tolerance level, they quit their
employment regardless of the consequences they
will face after that. A professional can only be
pushed so far.
In today’s world
one slip-up, confrontation, or
medical mistake while employed puts you on the
list for possible termination of employment.
is quite evident that today in 2013 hospital and
managed care employers are much more prone to
terminate your employment because of the
thousands of doctors waiting to take your job.
I’m talking about
the 50% of graduating medical
students that are headed for
The advantages of an
employed position today
(with horrendous educational debt hanging over
their heads) may not give large numbers of young
doctors much choice
in the matter.
“If you have a poor financial education,
you will always work for the rich.”
---Robert T. Kiyosaki
For the right doctor in the right circumstances
some of those employment advantages are...
schedules are usually 9 to 5, five
days per week. Some doctors have night-call
but very infrequently.
You are paid
starting immediately and remain
at that pay level for the length of your
contract or you agree to take on a
higher-level job with them. At Kaiser after
3 years you become
a partner and share in profits they make, on
top of your salary, unless they have changed
their compensation system
You have much
more time with your family.
are very good including health
insurance, medical malpractice coverage,
vacation time, medical meeting and education
You will have
higher paid and experienced
Once you have
experienced an employed
position, you always have the option to
leave and go into private practice, often
an established private medical
Final considerations concerning
Because I have practiced
a significant amount of
time in both the private and employed sectors,
it allows me to understand why doctors make the
decisions they do regarding their medical
My strong belief is
when you permit yourself to
settle into an employed position practicing
medicine, you are inevitably destroying a
significant amount of the talent, skills and
knowledge that you spent so much time and money
then never use.
In doing so you have
in a sense betrayed
yourself by eliminating opportunities you would
otherwise have to magnify your ultimate
potential as a physician, to reach complete
fulfillment, and to drive your skills and
knowledge to the maximum you are capable
The failure you should
consider here, and
happens here, is the result of the sequential
series of choices you made
along the way.
It’s not that you can’t
fix it, but that most
don’t make any attempt to step out of a less
than satisfactory sticky situation for any of a
“You cannot improve your future if you are not
willing to try something new and risk
making mistakes and learning from them.”
--- Robert Kiyosaki
The way I view physician
employment may distress
who in your medical life has ever
pointed out to you what you are leaving behind
in the process. I understand that you may not
have a choice of how you spend your medical
career, but you should understand clearly the
compromises you are making as an
The future of medical
education is predictable.
With the elimination of private medical practice
in our country soon, it is quite obvious that
medical education will need to be restructured
to supply doctors who will fit into employed
Graduating physicians must
be mentally trained
to be satisfied with “managed care” medicine and
are willing to tolerate a significant lack
professional independence. Any doctor who thinks
that this authoritarian infrastructure of health
care won’t happen in the rural areas doesn’t
truly understand the extensive nature of the
“Creativity is letting go
me, I left a lot of things behind during my
employment years, which I regret to
this day. A few examples of
those I have told
you above. But, there are many more and some
even worse to think about.
The author, Curt Graham, MD, and
experienced physician, author, marketer
expert in medical practice business and
marketing strategies, motivator of
in the business world,
published widely in web article
in Modern Physician and Medical
Economics Magazines, and has three books
Discover how to make your medical
practice flourish and
all expectations with simple business
and marketing strategies.
Click this link
All Rights Reserved
who are employed will find
themselves in the same situation
that this parachutist
always be administrative and peer
alligators ready to sink their teeth
into you. And if you are not able to
discipline yourself to that kind of
career life, you'd better already
have a back-up plan for the rest of
your medical career. Practicing
medicine in that sort of environment
will eventually become intolerable
You are trained
during medical school to be an
independent thinker and practitioner.
Those virtues are lost when you are
1985, his father died, leaving behind a neighborhood tavern
that was losing money and a mountain of debt accumulated
keeping the joint open. John juggled it with the opening of
a new, hopefully better business,
is the 3rd largest pizza chain, behind Dominos
and Pizza Hut, with $3-billion in annual revenue. Papa
John’s. Better Ingredients. Better Pizza. John Schnatter
aka. Papa John follows “characters” like Col. Sanders and
Dave Thomas, fast food chain founders who became the iconic
figureheads of their companies – themselves the key
differentiator in a crowded field. An ingredient.
But what are the other key ingredients? How do
you go from one tiny shop in a small Indiana town to a
global empire and a personality brand everyone knows?
This is the question everyone could ask themselves.
Since this is the day of casting the rich and successful as
villains, an answer to that question is: luck +
viciously profiteering from others’ misery; in John’s case,
slavery i.e. low wage workers and selling poison that causes
obesity. He was not unaware; he constructed his home to be
deceptive, tunneling underneath, to hide his multi-car
garage and movie theater. But then he slipped.
Here is how
unfunny comedian Bill Maher reacted, after John made it
known that a doubling of health insurance costs for the
80,000 employees in his system was an economic bomb they
could not simply absorb:
filthy-rich founder of Papa John’s, John Schnatter
said he’d cut his employees’ hours to avoid the costs of
ObamaCare. This is where I’d normally suggest boycotting
Papa John’s, but that’s like telling people to boycott
sadness. Nobody eats Papa John’s because they like it. They
eat it because Dominos won’t deliver to crack houses.”
wasn’t said in late night oblivion on cable. It was in
Maher’s editorial in The New York Times. Schnatter has been
dealing with an orchestrated, relentless political and media
attack ever since hosting a Romney fundraiser and having a
video go viral on You Tube in which Romney said: “Who would
have imagined pizza could build this! What a home this is!
What grounds these are! The pool! The golf course! If a
Democrat were here, he’d say no one should live like this.
But Republicans come here and say everyone could
calling attention to John’s wealth, Romney turned the
friendly, red shirted guy seen in his pizza places watching
over quality, even delivering pizza himself – Papa’s in
the house! into a red-eyed demonic
Then, when John made a comment about the structural changes
in employment ObamaCare would force on his and countless
other companies, the media pounced. His company’s #1 asset,
his image, put at risk, and costly PR combat required.
Fortunately, the average consumer is not all that dialed
into these things, and if they have Papa on their speed
dial, this too shall pass. But it speaks to the dangers in
Looking at anyone like John late in their story, when the
mansions, the cars, the flashy donations (his, a 55,000 seat
Papa John’s stadium at the University of Louisville), etc.
have come, no one sees the ugly, grimy, fighting for
survival beginnings, the flop sweat and sleepless nights
wondering if this’ll be the week payroll won’t be met, the
So here is the real answer to how you go from a small
shop to a global empire and earn your wealth. In
1985, John was out late at night, night after night, fishing
soiled copies of customer lists and delivery notes from
dumpsters behind Dominos outlets, so he could directly
pursue those customers and persuade them to try his better
pizza. (It reminds me of me, putting my lead generation
cards under windshield wipers of cars in hotel parking lots
where someone else was holding a seminar.)
do whatever it takes. You do what no one else will do. You
risk as others will not. You even steal – as this dumpster
diving was theft; it’s said there’s a crime behind
every fortune. You scrap and struggle and survive and find a
way forward and upward. There is no other answer.
DAN S. KENNEDY
is a serial, multi-millionaire entrepreneur; highly paid and
sought after marketing and business strategist; advisor to
countless first-generation, from-scratch multi-millionaire
and 7-figure income entrepreneurs and professionals; and, in
his personal practice, one of the very highest paid
direct-response copywriters in America. As a speaker, he has
delivered over 2,000 compensated presentations, appearing
repeatedly on programs with the likes of Donald Trump, Gene
Simmons (KISS), Debbi Fields (Mrs. Fields Cookies), and many
other celebrity-entrepreneurs, for former U.S. Presidents
and other world leaders, and other leading business speakers
like Zig Ziglar, Brian Tracy and Tom Hopkins, often
addressing audiences of 1,000 to 10,000 and up. His popular
books have been favorably recognized by Forbes, Business
Week, Inc. and Entrepreneur Magazine. His NO B.S. MARKETING
LETTER, one of the business newsletters published for
Members of Glazer-Kennedy Insider's Circle, is the largest
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In Every Issue:
|1. Powerful Business
and Marketing Articles
You Can Easily Adapt to Your Own Medical Practice.
2. Dr. Graham's Practice Views And Opinions That Should
Provoke New Ideas For You to Act on.
Your Medical Practice Potential, Income, and
4. Businesses For
Your Kids. The
Smartest Thing A Parent Can Do For Their
Children Is To Teach Them Business Tactics And
Strategies, And Stimulate Them To Start Their Own
At Any Age.
5. VIP Newsletter Articles Library. Cutting
Articles Telling You How To Grow Your Practice In Any
6. Practice Ideas And Tips For Improving
7. Library Of My Views About Medical Practice.
Alternatives, Problem Solutions, And The Things You
Should Do and Should Not Do.
8. List Of My Medical
Business Websites Meant To
Offer You Another Whole New Look AT How Your Medical
Practice Interacts With Other Medical Career Demands +
9. Humor In Small t.i.d. Doses. Meant to lighten your
stress load, if even for just a few minutes.
Social Media in Healthcare:
LinkedIn.com is a
professional networking site for 200 million members to find
jobs, connecting to other healthcare professionals.
PatientsLikeMe.com is a website for patients with
serious diseases such as ALS and MS. Paul Wicks,
neurophysiologist and research director is creating a
learning health care system for these medical problems that
there is no treatment for.
provides a cloud-based med.
records system for doctors.
patients to give their reviews of doctors.
ZocDoc.com is a service
that doctors subscribe to to handle their patient
HealthTap.com is a hub
of 1.2 million doctors world wide who field medical
questions from anyone, anywhere.
All four sites is where patients
are able to compare doctors, write reports about doctors,
and do background checks on doctors.
Fortune Mag.Apr. 29, 2013, pg 54
"After eating an entire bull, a mountain lion felt so good
he started roaring. He kept it up until a hunter came along
and shot him.
The moral: When you're full of bull, keep your mouth
Student, A. J. Forsythe, at
Calif. Polytechnic State Univ. had always been a tinkerer.
He decided to fix his own mobile phone, did it, saved over
$300 in repairs. He went on to create iCracked--the iPhone,
iPod, and iPad repair and buyback service out of his dorm
He partnered with Dave Mazurek and they have
a flourishing business in York, PA.
Entrepreneur, May 2013
"The more difficulties one has to encounter, within and
without, the more significant and the higher in inspiration
his life will be."
Views I Only
Share With My Friends--
What my medical career
and how it can help
you manage your medical practice business at
highest level of expertise.
Best Education and Career Sites:
Are Capable Of-
When you want to understand
modern day kids are capable of
and have the ability to
do, regarding starting a
business of their own, then hit
the link below and give yourself a dose of inspirational
the keys to your
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need expert help and advice, and when........
don't know where to turn
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reliable help with your battle to fight the
external forces that compromise your practice
revenue and growth.
want to improve
your medical practice income
dramatically in a short period of time.
prefer to find the means to reach your
level of practice income and
demand effective and reliable
preventing the financial collapse of your
determined to find ways to
combat govt. fee
restrictions that continue
what you are missing in your
medical business are implementation of
business principles and marketing strategies.
want to do it yourself
and save a
bunch of money.
sick and tired of putting up with what you are
being forced into doing
with your practice to
no other physician author is making
any effort to tell you what to do and how to
do it effectively
to reach your expectations
you had for your medical career when you
understand the severity of being in a business
being taught the business
knowledge to run it profitably.
insist on having a
blueprint for your medical
practice business that
provides every key to
your practice success at the highest level.
for doctors who invest.......
For Investing advice:
2.The Palm Beach
3. Retirement Millionaire
published by David Eifrig Jr., MD, MBA,
Ophthalmologist, stock market expert.
(my choice) Subscriptions
Note: I have no personal or
business connections with these references
other than subscriptions to their
publications. I suggest them because I
do think they have unique value for investors.
My Other Medical Websites
coaching.com (coming July 2013)